To be included in health care decisions, patients must be able to effectively express personal health concerns and preferences, and understand information provided by clinicians. This communication is often problematic, but may be even more so for patients with backgrounds and expectations that differ from those of clinicians. One patient population that appears to be particularly a risk for failures of communication is young children. One of the consequences of poor child-clinician communication is that children are often excluded from active participation in health care. Children are not seen as capable communicators and are thus dependent on others (e.g., parents) to manage their care. However, little existing research has directly addressed children's management of health care information. The specific aim of the research described in this proposal is to explore the exchange of information between children and clinicians during clinical encounters. Thirty 5-year-old children in the study will be interviewed following a simulated well child health assessment. Interviews will probe for children's memories and interpretations of selected elements of the clinical encounter. One set of analyses will focus on the match between the language and conceptions of children and the language and conceptions of the clinician (as reflected in the medical record). A second set of analyses will address children's understanding of the health relevance of the information exchanged in the encounter. The ultimate goal of this research is to improve children's ability to participate in health care decision making. Knowledge gained in this study will be used to design an intervention to improve children's awareness of and interest in information about their own health. In addition, the results of this research project may be used to improve the delivery of services by health care workers by illuminating the ways in which children think and communicate about their health.